Healthcare Provider Details

I. General information

NPI: 1962405175
Provider Name (Legal Business Name): FREDERIC A STELZER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 05/26/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 N CEDAR CREST BLVD SUITE 110
ALLENTOWN PA
18104-2309
US

IV. Provider business mailing address

1501 N CEDAR CREST BLVD SUITE 110
ALLENTOWN PA
18104-2309
US

V. Phone/Fax

Practice location:
  • Phone: 610-821-2828
  • Fax: 610-821-7915
Mailing address:
  • Phone: 610-821-2828
  • Fax: 610-821-7915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD018896E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: